CATEGORY 76 AUSTRALASIAN DENTIST CLINICAL address any potential late-onset issues, the patient will have scheduled follow-up appointments. ese will take place at three months, six months, and one year posttreatment. However, the patient has been made aware of more invasive treatment options that may become necessary if symptoms arise in the future. Final remarks Managing a tooth with deep caries approaching the pulp chamber, as with any successful treatment outcome, begins with an accurate diagnosis. e decision to preserve the pulp hinges on clinical evaluations, including symptoms, radiographic data, and pulp sensibility testing [Stangvaltaite et al. 2013]. In this case, since the patient did not display symptoms of irreversible pulpitis, the primary objective was to maintain the vitality of the pulp and prevent further disease progression. Radiographic examination indicated likely pulpal exposure due to caries, making rubber dam isolation essential. e application of MTA highlights a minimally invasive approach, aiming to preserve natural tooth structure and function. Using an MTA block with a thin burnisher, the MTA vpt was successfully applied for direct pulp capping. GrandioSO Heavy Flow was ideal for sealing the MTA plug prior to the bonding protocol with Futurabond U. GrandioSO Unlimited was e ectively used for restoring the deep margin of the cavity, noted for its bulk placement capability, short curing time, and high ller content (91 %w/w). is makes it suitable for posterior restorations that are di cult to access and require strong compressive strength, nevertheless, show excellent aesthetics. Confusion frequently arises when de ning the di erence between pulp capping and partial pulpotomy. Partial pulpotomy removes 2-3 mm of the pulp tissue at the site of exposure; this technique is used for removing the super cial layer of infected or in amed tissue. Pulp capping does not involve any pulp tissue removal; instead, the biomaterial is placed in direct contact with the pulp tissue [ESE 2006]. is case demonstrates successful pulp capping, facilitated by the ease of material mixing and handling, enhancing incorporation into routine dental practice. Presenting all available treatment options from least to most destructive is crucial. Innovative materials like MTA vpt expand options for vital pulp therapy. To allow for easier placement of the material an MTA block and a thin instrument can be advantages for neat pin-point placement, ensuring that the material does not contact the amelodentinal junction. Moreover, sealing the material in its entirety prior to commencing the usual bonding protocol is essential. Flowable composites like GrandioSO Heavy Flow WO assist in sealing due to their surface a nity and visibility at the base of a cavity. e patient experienced a successful outcome, with complete resolution of the symptoms at the two-week follow-up, and regular monitoring will continue. e patient was also informed of more invasive future treatment options, should symptoms recur. is approach underscores the importance of conservative techniques and advanced materials in modern dental practice, ultimately providing a bene cial outcome for the patient. u Literature Bergenholtz G (2000) Evidence for bacterial causation of adverse pulpal responses in resinbased dental restorations. Critical Reviews in Oral Biology and Medicine 11, 467–80. Cox CF, Hafez AA, Akimoto N, Otsuki M, Suzuki S, Tarim B (1998) Biocompatibility of primer, adhesive and resin composite systems on non-exposed and exposed pulps of non-human primate teeth. American Journal of Dentistry 11, S55–63 ESE (2006) European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006 Dec;39(12):92130. Lee SJ, Monsef M, Torabinejad M (1993). Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. J Endod. 19(11):541-4. Pameijer CH, Stanley HR (1998) e disastrous e ects of the “total etch” technique in vital pulp capping in primates. American Journal of Dentistry 11, S45–54. Pitt Ford TR, Torabinejad M, Abedi HR, Bakland LK, Kariyawasam SP (1996) Using mineral trioxide aggregate as a pulp-capping material. Journal of the American Dental Association 127, 1491–4. Stangvaltaite L, Kundzina R, Eriksen HM, Kerosuo E (2013) Treatment preferences of deep carious lesions in mature teeth: questionnaire study among dentists in Northern Norway. Acta Odontologica Scandinavica 71, 1532–7 World Health Organization (2017) Sugars and dental caries. Geneva, Switzerland: World Health Organization. WHO publication no: WHO/NMH/ NHD/17.12. Address for correspondence Dr. Ashish Soneji Queen Square Dental Clinic Bristol, United Kingdom Figure 11: Immediate Post-operative result of the completed restoration on 37 Figure 12: Post-operative intraoral periapical radiograph of 37. Displaying a very deep restoration showing the thin layer of MTA vpt placed at base of the cavity and the restoration completed with GrandioSO Unlimited NEW PRACTICE? ASSOy QoZ Ior the 6yGQey AustrDOLDQ 'eQtLstry AZDrGs Are you the best
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